SHORT-TERM OUTCOME OF OPERATED TRAUMATIC BRAIN INJURY PATIENTS FOR INTRACRANIAL HEMORRHAGE AT TIKUR ANBESSA SPECIALIZED TEACHING HOSPITAL (TASTH), ADDIS ABABA, ETHIOPIA

Authors

  • Hagos Biluts AAU,COHS,SOM,department of surgery
  • Azarias Kassahun
  • Mersha Abebe

Abstract

Background: Traumatic brain injury is the leading cause of death and disability in people younger than 40 years of age worldwide.

Objective: The study primarily aims at assessing the short-term outcome of patients operated for traumatic intracranial hemorrhage.

Patients and Methods: This is a hospital based cross sectional study on patients with traumatic brain injury at Tikur Anbessa Specialized Teaching Hospital in Addis Ababa, Ethiopia, between February 2013 and February 2014. Standardized and structured questionnaire was used to collect sociodemographic data. All patients with traumatic brain injury operated following intracranial hemorrhage were included. Glasgow Coma Scale was used to determine the outcome. Difference in proportions was examined using Chi-square test.

Results: The study reviewed 91 patients with traumatic brain injury. Their age ranged from 13 to 60 years with a mean (SD) of 32.3 (±12.1). Eighty-seven (95.6%) of the cases were males and 4(4.4%) females and 34(37.4%) of them cases had mild and 30(33%) had severe traumatic brain injury. Acute Epidural Hematoma was seen in 79(86.8%), Acute Subdural hematoma  had the highest proportion, 4/11(36.4%), of deaths and it was also significantly associated with unfavorable Glasgow Outcoma Scale at 3 months (p=0.03). Overall, the proportion patients who died was 18.7% with older patients (>50 years) had a significantly higher proportion of death (p=0.01). Most of the patients had favorable Glasgow Outcoma Scale ,unfavorable was seen in 22/30 (73.3%) and 17/30 (56.7%) of patients with severe traumatic brain injury at 3 and 6 months, respectively.

Conclusion: In conclusion, male predominance was substantially high. Acute Subdural hematoma  and old patients had high death rates and unfavorable outcome. Overall the death rate was not different from global figures.

 

Author Biography

Hagos Biluts, AAU,COHS,SOM,department of surgery

Department of surgery, neurosurgery unit ,Associate professor in Neurosurgeon and G. Surgeon

References

References

Winn RH: Youmans Neurological Surgery, 6/e, Elsevier Saunders, 2011

Jennet B: Epidemiology of head injury. J NeurolNeurosurg Psych 60: 362-69, 1996

Braakman R, Gelpke GJ, Habbema JDF, et al: Systematic selection of prognostic features in patients with severe head injury. Neurosurgery 6: 362-370, 1980

Tagliaferri F, Compagnone C, Korsic M, et al. A systematic review of brain injury epidemiology in Europe.ActaNeurochir (Wien) 148:255–268, 2006

Bullock MR, Chesnut R, Ghajar J, et al. Guidelines for the surgical management of traumatic brain injury. Introduction. Neurosurgery 58 (S2):1–3, 2006

Browder J. A resume of the principal diagnostic features of subdural hematoma. Bull NY Acad Med 19: 168-176

Munro D. Cerebral subdural hematomas: a study of three hundred and ten verified cases. NEJM 227: 87-95

Voris HC. The diagnosis and treatment of subdural hematomas. Surgery 10: 447-456

Cooper PR, Rovit RL, Ranshoff J. Hemicraniectomy in the treatment of acute subdural hematoma: a re-appraisal. SurgNeurol 5: 25-28

Jamieson KG, Yelland JDN. Surgically treated traumatic subdural hematomas. J Neurosurg 37: 137- 149, 1972

McKissock W, Richardson A, Bloom WH. Subdural hematoma: a review of 389 cases. Lancet 1: 1365-69, 1965

Talalla A, Morin MA. Acute traumatic subdural hematoma: a review of one hundred consecutive cases. J Trauma 11: 771-777, 1971

Gennarelli TA, Spielman GM, Langfitt TW, et al. Influence of the type of intracranial lesion on outcome from severe head injury. J Neurosurg 56:26–32, 1982

Alliez JR, Hilal N, Kaya JM, et al. Epidural intracranial hematomas: practical issues revealed by management of 100 recent cases. Neurochirurgie 51:464–470, 2005

Servadei F, Compagnone C, Sahuquillo J. The role of surgery in traumatic brain injury. Current Opinion in Critical Care 13: 163-168, 2007

Patel HC, Bouamra O, Woodfrod M et al: Trends in head injury outcome from 1989 to 2003 and the effect of neurosurgical care: and observational study. Lancet 366: 1538-44, 2005

Heiden JS, Small R, Caton W, et al: Severe head injury and outcome: prospective study, in Popp AJ, Bourke RS, Nelson LR, et al (eds): Neural Trauma. New York: Raven Press, 1979

Jennett B, Bond M. Assessment of outcome after severe brain damage. Lancet 1(7905): 480-484, 1975

Jennett B & Teasdale G: Management of head injuries. Contemporary Neurology Series Philadelphia: FA Davis Co., 1981

Bahloul M, Chelly H, Ben Hamida M, Ben Hamida C, Ksibi H, Kallel H, Chaari A, Kassis M, Rekik N, Bouaziz M. Prognosis of traumatic head injury in South Tunisia: a multivariate analysis of 437cases. J Trauma 57(2): 255-261, 2004

Phoebe SY C, Jenny MY L, Janice HH Y, Colin AG, Timothy HR. Outcome of traumatic extradural hematoma in Hong Kong. Injury 38:76-80, 2007

Gomez PA, Lobato RD, Boto GR, De la Lama A, Gonzalez PJ, de la Cruz J, Age and outcome after severe head injury. Acta Neurochir (Wien) 142: 373-381, 2000

Shameem A, Shabbir K, Deepak A, Sharma BS. Outcome in head injured patients: Experience at a level 1 trauma center. Indian Journal of Neurotrauma 6:119-122, 2009

Downloads

Published

2016-12-19

Issue

Section

Original Article